Provider Demographics
NPI:1689307977
Name:KREN, KEYSHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KEYSHA
Middle Name:
Last Name:KREN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12499 BRANTLEY COMMONS CT STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5694
Mailing Address - Country:US
Mailing Address - Phone:239-278-3443
Mailing Address - Fax:239-278-3550
Practice Address - Street 1:12499 BRANTLEY COMMONS CT STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5694
Practice Address - Country:US
Practice Address - Phone:239-278-3443
Practice Address - Fax:239-278-3550
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11523103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical